Individual
DR. STEVEN JOHN FAHSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
119 W LAKE ST, LAKE MILLS, WI 53551
(920) 648-2912
(690) 648-8219
Mailing address
119 W LAKE ST, PO BOX 47, LAKE MILLS, WI 53551
(920) 648-2912
(690) 648-8219
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0003219
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33460200
—
WI
Enumeration date
10/19/2006
Last updated
07/08/2007
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